Provider Demographics
NPI:1871026468
Name:NWORU, CHINASOKWU A (MED, MS, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:CHINASOKWU
Middle Name:A
Last Name:NWORU
Suffix:
Gender:M
Credentials:MED, MS, OTR/L
Other - Prefix:MR
Other - First Name:CHINASA
Other - Middle Name:A
Other - Last Name:NWORU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, MS, OTR/L
Mailing Address - Street 1:419 JEFFERSON AVE APT 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-3294
Mailing Address - Country:US
Mailing Address - Phone:732-306-5078
Mailing Address - Fax:
Practice Address - Street 1:419 JEFFERSON AVE APT 1R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-3294
Practice Address - Country:US
Practice Address - Phone:732-306-5078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist